The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Brown J, Martin-Robins D, Cooper A.
Background: Little is known about the palliative care needs of people living with a mental illness and a life-limiting illness.
Aims: To gain an understanding of palliative care need and service utilization in adult inpatients with mental health issues across a metropolitan area health service in Perth, Western Australia.
Methods: Data were collected at four sites from patient medical records. Adult patients who were admitted at study sites' mental health units were eligible for inclusion.
Results: In total, 192 patient records were reviewed. Almost one-third of patients (32%, n = 61) had at least one condition listed in the Gold Standards Framework, and 30% (n = 18) of these could have potentially benefited from palliative care. There was evidence of one patient receiving some form of palliative care.
Conclusions: In this cohort, there was unmet need for palliative care, especially among older adults. The majority of patients with potential palliative care needs were admitted to older adult mental health wards. There are missed opportunities to provide holistic care to adult inpatients with mental health issues experiencing life-limiting conditions, likely to result in poorer symptom control and reduced quality of life. Approaches to identify and respond to palliative care needs in mental health settings need to be adopted.
Lim CED, Sanchez C, Chen H.
Introduction: Palliative care addresses the comprehensive needs of advanced-stage cancer patients, enhancing their quality of life. However, due to cultural and linguistic differences, Chinese Australians encounter substantial barriers to accessing these services.
Aims: This study aimed to investigate the barriers preventing Chinese Australians from accessing palliative care services.
Methods: Surveys and interviews were conducted with Chinese Australian cancer patients and their caregivers to assess their awareness, understanding, and challenges related to palliative care.
Results: Among 136 surveyed and eight interviewed participants, a significant lack of awareness and numerous misconceptions about palliative care were evident, with language as the primary barrier despite strong interest in such services.
Discussion: The results indicate a need to improve the awareness and accessibility of palliative care for the Chinese Australian community. Local health authorities and medical associations should collaborate in developing and disseminating culturally and linguistically appropriate information to increase service uptake among ethnic groups in Australia.
Luc I, Dadich A, Laurence C.
Background: As in many countries, Australians are living longer and experience greater rates of chronic conditions. This can require greater use of palliative care services. However, there is limited research on how many people would benefit from palliative care. The aim of this study is to estimate the current and future need for palliative care services in Australia and within geographical regions.
Methods: Using national mortality data and population projections, the study used two methods to estimate the observed (2011 to 2022) palliative care need in Australia by age, sex, and geographical area. These were: 75% of all deaths would require palliative care; and a diagnostic based approach on main underlying cause of death. These methods were used to estimate the future need for palliative care, applying the proportion of palliative deaths to the Australian Bureau of Statistics projected deaths to 2042 using 75%, the 2022 proportion of diagnostic-based deaths, and the mean annual change in proportion of these deaths from 2011 to 2022. Analyses were also performed across sex, age group, geographical areas and disease group to identify areas of increasing palliative care need.
Results: The two methods demonstrated a growing need for palliative care in the observed and projected period. From 2011 to 2022, there was an 18 to 30% increase in the number of people who needed palliative care. From 2023 to 2042, there will be an increase of 37 to 65% in the number of people needing palliative care. People aged over 85 years, as well as people living with cancer and dementia are expected to drive the future need for palliative care. The need for palliative care in regional and remote areas is greater than that in the major cities.
Conclusion: Current workforce trends in Australia are unlikely to meet the growing need for palliative care. Future palliative care services must be developed in line with these findings and further research is required ensure an adequate supply of palliative care to match the expected demand.
Riggs DW, Patlamazoglou L, Simmonds JG, Snell T.
Abstract: All too often, humans who experience the death of a partner are directed towards other humans for support, ignoring the important role that animal companions play in the lives of many humans. For lesbians and gay men specifically - whose grief may be disenfranchised - animal companions may play a particularly important role. This paper reports on a secondary analysis of interviews with 10 Australian lesbians or gay men who had lost a partner due to non-HIV related issues. Six of the participants spoke impromptu about the importance of animal companions following the death of a partner. Thematic analysis resulted in the development of three themes: (1) animals provide comfort and company, (2) animals serve as a reminder of partners, and (3) animals give people a reason to go on. The paper concludes by considering the importance of speaking about animals in the context of research and practice related to human bereavement.
Button E, Virdun C, Mudge A, Donovan T, Singh GK, Yates P, et al.
Background: Acute inpatient care does not always align with the known palliative care needs and preferences of people with deteriorating health. The LEAHP (Listen, Empower and Act to improve Hospital Palliative care) bundle is a novel intervention combining collection and feedback of patient reported experience measures (PREMs), an understanding of context, co-design of a shared vision and facilitated clinician-led improvements in quality of care, for inpatients with palliative care needs. We describe the resource requirements for pilot implementation of the LEAHP bundle, and potential cost considerations for sustaining and spreading this initiative.
Methods: A prospective costing analysis was conducted alongside a pre-post implementation study between May 2022 and Nov 2023 across three wards in a large hospital in Australia. A health service perspective was taken, with costs collected during the study period and valued in 2023 Australian dollars. Costs included Project Team and Clinical Team labour, as well as non-labour resources. Time-driven, activity-based costing methods were adopted, with implementation activities categorised using a modified Expert Recommendations for Implementing Change (ERIC) Framework headings. A scenario analysis explored cost reductions that would support sustaining and spreading of the initiative.
Results: The total average cost of implementing the LEAHP bundle for each ward over approximately 12 months was $37,019; consisting of $26,289 (71%) Project Team, $8,870 (24%) Clinical Team, and $2,053 (5%) non-labour average costs. The greatest percentage of costs was attributed to the Facilitator (average $13,488 per ward, 36% overall) and the Research Nurse (average of $10,868 per ward, 29%). In a scenario analysis testing sustainment and spread, the total average cost of implementing the LEAHP bundle was an average of $25,251 per ward ($15,212 [60%] Project Team, $8,373 [33%] Clinical Team, and $1,667 [7%] non-labour costs) – 32% less than the base case.
Conclusions: Pilot implementation of the LEAHP bundle required investment from both the Project Team and Clinical Team to enable facilitation, collection of PREMs, an understanding of context, and engagement of clinicians to implement improvements for inpatients with palliative care needs. Sustainment would be contingent on the resources required for facilitation in a changing clinical context and on mechanisms for collecting and processing the PREM data. Future research is warranted to explore sustainable and widescale implementation of this promising intervention.
Last updated 30 April 2024